1. 1. The patient Female patient, 76 years old, Aortic stenosis, accepted for TAVI, Technical details: Porcelain aorta Aortic annulus: 21 x 23 mm

2. 2. The procedure Echo-guided femoral access, Crossing aortic valve (Amplatz left-2, Kimal straight), Balloon valvuloplasty (23 x 60 mm Z-Med balloon):

3. 3. The problem No crossing of the 26 mm CRS (whatever we did),

4. 4. The solution 6 Fr Pigtail in commissure into LV (“Buddy Pigtal”):

5. 5. The question The etiology of no crossing? - Is it patient related? - Is it anatomy related? - Is it device related? - Is it operator related? Did anyone else experience this problem? How did you solve the problem?